DESCRIPTION: (Applicant's Abstract) This investigation is designed to use data collected in a 14 year follow-up study of a large geographically-defined, well-characterized cohort of diabetic patients. We will examine the following relationships: serum lipids and uric acid, microalbuminuria, pulmonary function, and cataract surgery to the progression of diabetic retinopathy and the incidence of macular edema and proliferative diabetic retinopathy; glycemia, blood pressure and diabetic retinopathy and performanced-based visua acuity status. The unique features of the study are that it is a population-based cohort of persons with Type 1 and Type 2 diabetes that was defined in 1980-1982 (n=2,366) and has been evaluated four times, most recently in 1994-1996. All evaluations have included the use of standardized examination, photography, and grading protocols. Many hypotheses that will be evaluated during the course of this grant have relevance to investigating possible causal pathways and for developing preventive strategies for long-term complications of diabetes.